Fisher, Pamela and Owen, J.M. (2008) Ecologies of practice and empowerment. In: BSA Medical Sociology Group Annual Conference, September 4th-6th 2008, University of Sussex, Brighton. (Unpublished)

While UK Government health policy stresses that health and social care agencies should ‘empower’ service users, it is argued here that this predominantly reflects a managerialist discourse, equating citizenship with individualized self-sufficiency in the ‘public’ sphere. Two research projects are discussed in this paper: the first project focused on policy and practice in relation to teenage motherhood in a city in the North of England; the second was part of a large research programme, Changing Families, Changing Food, and investigated the ways in which ‘family’ is constructed through policy and practice interventions concerning food and health. Drawing critically on Honneth’s politics of recognition, we suggest that formal health policy overlooks the inter-subjective processes that underpin a positive sense of self, emphasising instead an individualized ontology. While some research has positioned practitioners as one-dimensional in their adherence to the current audit culture of the public sector in the UK, our findings demonstrate how practitioners often negotiate audit-based ‘economies of performance’ with more flexible ‘ecologies of practice.’ The latter open up spaces for recognition through inter-subjective processes of identification between practitioners and service users. Ecologies of practice are also informed by practitioners’ experiential knowledge. However, this process is largely unacknowledged, partly because it does not fall within a managerialist framework of ‘performativity’ and partly because it often reflects taken-for-granted, gendered patterns. It is argued here that a critical understanding of ‘empowerment’, in community-based health initiatives, requires clear acknowledgment of these inter-subjective and gendered dimensions of ‘ecologies of practice’

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